Download Mitral Valve Disease

Mitral Valve Disease
What is Mitral Valve Disease (MVD)?
The mitral valve separates the heart's two main chambers, it acts like a one way
gate preventing blood flowing the wrong way round the heart each time it beats.
With Mitral Valve Disease the valve becomes misshapen and leaky. The leaky valve
allows blood to flow the wrong way through the heart, from left ventricle to left
atrium. This puts excess pressure on the heart and affecting how well it functions.
We do not know the cause of this disease, it just happens in some dogs as they get
older.
MVD is most common in older small breed dogs. Cavaliers are particularly prone to
this disease, but it can affect any breed of dog. Many dogs will live with it happily for
their whole life and it never becomes a problem. However in some dogs it will
progress and eventually will cause heart failure.
What is Heart Failure?
Congestive heart failure is the term we use when your dog's heart and body can no
longer cope with its level of heart disease and it starts to show obvious symptoms.
The common symptoms can be mild and hard to notice in the early stages of the
disease, often easily dismissed as just “slowing down” with age. Watch out for:
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Out of breath or refusing to exercise
Lethargy
Coughing
Change in breathing
Decreased appetite
Fainting/weakness/collapsing
When the heart starts to fail, the knock on effect is a build up of fluid on the lungs,
or sometimes in their abdomen. This will obviously affect your dog’s breathing. If
you notice a change in your dog's resting respiratory rate (how many breaths they
take in one minute) this is a really useful early warning sign, and it’s something only
you can check at home. When your dog visits the vets they are understandably
nervous or excited and as a result their breathing will be more rapid than at home. If
you were to record how many breaths your dog takes in a minute on a regular basis,
this is really useful information for us. If you notice this number start to increase, it’s
an early warning sign there may be a problem, so get your dog checked.
How is MVD Diagnosed?
Virtually all dogs with significant mitral valve disease will have a heart murmur
audible with a stethoscope. Often we will pick up on a murmur years before it ever
causes a problem. If we find a heart murmur we often recommend having a heart
scan. We use an ultrasound scan to look at the structure of the heart and take
various measurements of the heart. With the scanner we are able to see which way
the blood is flowing through the heart and can actually see the valve leaking. The
scan can also gives us an idea of how advanced the heart disease is. We also often
recommend doing other tests to check for other reasons your dog maybe showing
the symptoms they are, for example chest xrays to check for any other causes
coughing, blood tests to check for other reason for poor appetite or lethargy.
How is MVD Treated?
There is medication available to improve the quality of life of dogs with MVD, but
sadly there is no cure. There is no proven benefit to treating MVD early, ie before
any symptoms are shown, it does not appear to slow the progression of the disease.
We only need to start treating dogs if or when their MVD starts affecting them, ie
when you notice symptoms of the disease. There are a number of medications
available to treat MVD and most dogs need to be on a combination of tablets.
Treatment is always tailored to meet your dog's individual needs, within your budget
constraints.
Frusemide is a diuretic medication. It gets rid of any excess fluid build up by
making your dog wee more. So expect your dog to be a bit more thirst and wee
more on this medication
Vetmedin (pimobendan) is a medication to make the heart beat stronger, helping it
function better
Fortkor (ACE inhibitor) is a medication that dilates blood vessels away from the
heart, taking pressure off the heart and spreading it out around the body.
Tempora (spironolactone) is another sort of diurectic working in a similar way to
frusemide
Cardalis is a combination of an ACE inhibitor and spironolactone in one tablet
Diet We recommend specially formulated diets containing low sodium levels
Some dogs with MVD will also develop an arrhythmia (an abnormal heart rhythm).
To diagnose the type and cause of the arrhythmia we will normally perform an ECG
(electrocardiography). This measures the electrical impulses in the heart that control
the rate and rhythm of heart beats. Additional medication may be necessary if an
arrhythmia is found
Is it expensive?
Honestly... yes, it can be expensive to keep a dog on medication long term.
Treatment is lifelong; we are managing the condition rather than curing it. We will
always try our best to work with you to provide the best possible treatment within
your budget constraints. This is a rough guide to an average monthly cost for
medication for an average sized dog of 10-20kg.
*Doses are calculated according to weight and each dog’s individual needs, so costs will vary accordingly.*
Frusemide – £10
Vetmedin - £45
Fortekor - £50
Tempora - £15
Cardalis - £70
Provided your dog does well on medication we would just need to check them every
3-6 months to make sure they are ok to continue on their current doses of
medication, just as you or I would need to see the doctor regularly for a prescription
check up. We charge a standard consultation fee for this visit.
What’s the Prognosis?
This varies a great deal between dogs. Some dogs are diagnosed with MVD but
never go into heart failure, living normal lives and pass away from other age related
diseases. Generally speaking the average life expectancy of a dog after starting
medication (ie when their symptoms become reach a significant level) is about 1-2
years. The majority of dogs on medication for their heart disease do show a
significant improvement in their quality of life. Some dogs will surprise you and go on
for years on their heart tablets, but other dogs go the other way and despite our
best efforts deteriorate rapidly. It’s important to realise that almost every dog with
clinically significant MVD, on medication will need to be euthanized at some point.
They very rarely pass away peacefully at home. Making the decision to have your
dog put to sleep is never easy, but we'll do our utmost to guide you through the
process and make the decision as stress free as possible.
If you have any other questions regarding MVD please just contact us and we’ll do
our best to help you
01527 831 616